U.N. Adviser Discusses Creative Financing for Global Health

With globalization’s great power comes great responsibility. Dr. Philippe Douste-Blazy, under-secretary-general of the United Nations, expressed that sentiment Thursday during a lecture at Ronald Reagan UCLA Medical Center about innovative financing to help developing nations acquire health care.

“During the last 20 years, we saw the globalization of the economy, the globalization of communication, but not the globalization of solidarity,” said Douste-Blazy.

In an effort to treat HIV/AIDS, malaria and tuberculosis pandemics in areas such as sub-Saharan Africa, Douste-Blazy helped establish UNITAID, a global partnership  that funds medicine and its distribution to developing countries through creative financing strategies.

Both cash-rich and cash-poor nations are struggling with their economies, said Dr. Thomas J. Coates, director of the David Geffen School of Medicine's Global Health Program. Douste-Blazy came up with a plan.

“Because I am French,” Douste-Blazy quipped, “I immediately thought of taxation.”

In 2006, the organization instituted a €1-tax on airline tickets purchased in Europe. For international flights, the tax increases to €4.

“That’s for economy class,” Douste-Blazy said. “If you take first class, you can pay more.”

In the five years since the tax was implemented, UNITAID has raised approximately $2 billion. This tax represents 70 percent of the organization’s financial base, according to the UNITAID website. Five of UNITAID's 29 member countries – Chile, France, Republic of Korea, Mali and Niger – are participating.

But for the United States, which has been hit hard by a recession and where average domestic airline ticket prices have increased, additional taxes on consumers could raise eyebrows.

“For the U.S., it’s difficult to explain,” he said. “Taxes are not in the culture.”

Douste-Blazy’s answer is to make U.S. donations voluntary. Beginning later this year, UNITAID will launch a pilot study with partner organization UNICEF that offers airline ticket customers the option to donate a small amount to the organization.

“That is the future for the U.S.,” he said, “voluntary contributions.”

Ninety-three countries receive UNITAID funding, and 8 out of 10 children on therapy for HIV have been treated with UNITAID funds, Douste-Blazy said.

Another UNITAID strategy is to lower the cost of medicine by negotiating long-term relationships with pharmaceutical companies.

“We can give you $100 million every year for 10 years,” Douste-Blazy said, referring to the deal with the companies. “Can you reduce the price, please?”

In fact, in July UNITAID and partner organization Medicines Patent Pool signed a license agreement with California-based pharmaceutical company Gilead Sciences to make medicine available at a lower cost and in an easier-to-use dosage.

When asked how he saw the long-term future of this program, Douste-Blazy said improving public health systems is UNITAID's goal.

“That is the next step for innovative financing,” he said.